Wos İndeksli Yayınlar Koleksiyonu
Permanent URI for this collectionhttps://hdl.handle.net/11727/4807
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Item Comparison of 10 versus 20 sessions tap water iontophoresis efficacy in the treatment of palmoplantar hyperhidrosis(2022) Vural, Ayse Tuncer; Ozcan, Deren; Gulec, Ayse Tulin; https://orcid.org/0000-0001-8770-5721; 34982502; AAQ-4123-2021Background Tap water iontophoresis (TWI) is an effective treatment option for palmoplantar hyperhidrosis (HH). However, the optimal number and frequency of TWI sessions to control profuse sweating are unclear. Objective To compare the efficacy of 10 and 20 sessions of TWI in patients with palmoplantar HH and determine the adequate number of sessions to achieve a favorable clinical response. Methods Eighty patients treated with TWI for palmoplantar HH were included. The alteration in sweating intensity considering the mean value of gravimetric measurement and mean visual analog scale (VAS) scores after the 10th and 20th session of TWI were calculated. The difference between performing 10 and 20 sessions of TWI in providing improvement of HH was analyzed. We also conducted a telephone-based inquiry to determine the patients' outcome. Results The reduction in sweating intensity was significant both after the 10th (p < 0.001) and 20th (p < 0.001) sessions when compared with the basal level considering gravimetry and VAS. When the mean sweating intensity after the 10th and 20th sessions were compared, no difference was observed gravimetrically (p = 0.03); the difference between the mean score of VAS after the 10th and 20th sessions (p < 0.001) was significant. Eleven and nine patients not considering a maintenance or an alternative treatment had lower and same sweating intensity as compared with the baseline, respectively. Conclusion Ten TWI sessions within two weeks for managing palmoplantar HH are adequate to achieve a clinical response. However, the patients are more satisfied when they receive 20 sessions instead of 10 sessions of TWI.Item Is Clipping Superior to Cauterization in the Treatment of Palmar Hyperhidrosis?(2014) Findikcioglu, Alper; Kilic, Dalokay; Hatipoglu, Ahmet; 23839873Background Endoscopic thoracic sympathectomy has been accepted as the most effective treatment for palmar hyperhidrosis (PH). However, there is a debate regarding the surgical techniques in terms of effectiveness, recurrence, and reversibility. In this study, sympathetic chain disruptions were compared in terms of whether the clipping or ablation technique had an effect on the long-term outcomes of patients who underwent thoracic sympathectomy for primary PH. Patients and Methods All patients who underwent video-thoracoscopic sympathectomy for PH between May 2008 and October 2011 were included. Single-port bilateral sympathectomy was performed depending on the sweat distribution. As a standard approach, rib-based terminology was used to describe the blockade level of the sympathetic ganglia, and single-level R3 sympathectomy (between R3 and R4) was performed in all patients. The type of sympathectomy was changed. Monopolar electrocautery was first performed and 5-mm clips were then used for nerve disruption. Both techniques were evaluated and compared in terms of effectiveness, reversibility, and recurrence. Results Cauterization of the sympathetic chain was applied in 28 (47%) (Group A) patients and clipping in 32 (53%) patients (Group B). CH was the most common adverse effect and was observed in 43 (71.6%) patients (Group A, 71.4%; Group B, 71.8%; p = 0.8). The success rate was 93% for Group A and 100% for Group B (p = 0.15). The satisfaction rate for Group A was 83% and for Group B was 86% (p = 0.77). In Group A two patients (7%), and in Group B three patients (9%) requested reversibility because of severe compensatory hyperhidrosis. Overly dry hands were the other most common side effect and were identified in 12 (25%) patients. Recurrences were observed in 11 patients in Group A and 4 patients in Group B (19 vs. 6%; p = 0.01). The mean follow-up time was 33 +/- 10.5 months (range, 13-53 months). Conclusion Both clipping and cauterization are highly effective for the treatment of PH. The methods are comparable in terms of effectiveness and side effects despite the fact that the recurrence rate was higher in the cauterization group. Potential reversibility of compensatory sweating was not observed in our series. Identification of ideal candidates for surgery and education of patients about the permanent side effects of sympathectomy might make these techniques more convenient.